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目的:探讨慢性乙型肝炎(慢性乙肝)患者肝组织中真核细胞翻译启始因子2α(p-elF2α)及活化转录因子4(ATF4)的表达水平及其与肝纤维化间的关系。方法:纳入2016年1月至2019年1月淮安市第四人民医院共158例慢性乙肝患者穿刺活检肝组织标本。免疫组织化学染色分别评估不同肝纤维化分期间p-elF2α、ATF4的表达水平差异，并用Spearman秩相关分析其相关性。结果:肝脏标本病理结果提示纤维化各分期分别为S0期19例，S1期29例，S2期42例，S3期35例，S4期33例。免疫组化结果显示纤维化组的p-eIF2α及ATF4水平显著高于正常对照组(n P<0.001)，不同纤维化程度分期之间的p-eIF2α及ATF4水平差异有统计学意义(n P<0.01)。慢性乙肝患者肝纤维化等级与肝组织中p-eIF2α及ATF4染色得分间呈正相关(n r＝0.473，0.422，n P<0.05)。n 结论:慢性乙肝患者肝组织的纤维化程度与p-eIF2α及ATF4表达呈正相关，p-eIF2α-ATF4通路激活可能参与慢性乙肝纤维化过程。“,”Objective:To investigate the expression of eukaryotic translation initiation 2α (p-elF2α) and activated translation factor 4 (ATF4) in liver tissues of patients with chronic hepatitis B and their correlation with liver fibrosis.Methods:From Jan.2016 to Jan.2019, 158 cases of chronic hepatitis B patients were enrolled in our hospital. The expression levels of p-elF2α and ATF4 in different stages of liver fibrosis were evaluated by hematoxy-eosin (HE) and immunohistochemical staining, and the correlation was analyzed by Spearman rank correlation.Results:The pathological results of liver specimens showed that there were 19 normal controls (S0), 29 S1, 42 S2, 35 S3 and 33 S4 in each stage of fibrosis. The levels of p-eIF2α and ATF4 in fibrosis group were significantly higher than those in normal control group (n P< 0.001). Additionally, the levels of p-eIF2α and ATF4 in different stages of fibrosis were significantly different. The grade of hepatic fibrosis was positively correlated with the scores of p-eIF2α and ATF4 staining in liver tissues, and the correlation coefficients were 0.473 and 0.422 respectively (n P< 0.05).n Conclusions:Hepatic fibrosis in patients with chronic hepatitis B is positively correlated with p-eIF2α and ATF4. p-eIF2α-ATF4 pathway may involve in the process of chronic hepatitis B-induced hepatic fibrosis.